Belize has a total population of 370,000 of whom approximately 42% are under 25 years of age. Although an upper-middle-income country by World Bank classification, the heavily indebted,
highly vulnerable to economic and disaster shocks, and weak national capacity of Belize disguises and denies significant rates of poverty, unemployment, chronic malnutrition, drug abuse
and violence as well as other specific conditions that drive the HIV epidemic. The country is negatively impacted by a severe “brain drain” problem, losing many professionals,
including health care workers, to other countries. This has serious implications for the provision of adequate health care, which is provided mostly by the Government.

Related to HIV/AIDS epidemic, Belize has the highest HIV prevalence in Latin America and the 5th highest in the Caribbean, with estimated adult prevalence of 1.4% for persons 15-49 years,
and more than 3,100 people living with HIV/AIDS.

Based on a Behavioral Sero-Prevalence Survey (BSS) conducted in 2012 by the HIV Unit of the Center for Health Studies of Del Valle University of Guatemala in collaboration with the
Ministry of Health of Belize National TB, HIV & other STIs Program, it was determined that the prevalence rate amongst MSM was at 13.85% (19/136). This being the highest prevalence
compared to other Key Populations (KP) in Belize. There is no official data available for the trans-population in Belize.

While the results from the BSS may suggest that the HIV epidemic in Belize is concentrated among men who have sex with men, comparisons should be conducted with caution considering the
small sample size used in this study. Nevertheless, an earlier study conducted in 2001 by Multicenter Study in Central America (EMC) suggested that HIV prevalence among men who have sex
with men in Belize is the highest reported in the Central American region.

Both statistics suggest that MSMs in Belize have a high level of vulnerability for HIV; however, no official estimate has been conducted to determine the size of this population in
Belize, and thereby the country is unable to determine the extent of the problem for MSMs, as well as for the trans-population for whom no representative data is available.

The purpose of the consultancy is to conduct a population size estimate for Men who have Sex with Men (MSM) and trans in Belize as key populations in the country in order to ensure
resources are appropriately targeted to adequately cover the populations in need of HIV prevention, treatment and care services.